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Ezenwosu I, Ezenwosu O, Mbachu C, Itanyi I, Aguwa E. Effect of nutrition education on nutritional status and serum zinc level of HIV and AIDS clients: implication for care in resource-limited settings. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2022; 21:270-276. [PMID: 36102067 DOI: 10.2989/16085906.2022.2087532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 05/31/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
Background: People living with HIV or AIDS in resource-limited settings are faced with challenges in their nutrition and micronutrient levels. This study aimed to determine the effect of nutrition education on the nutrition status and serum zinc level of HIV and AIDS clients, and its implication for HIV care in resource-limited settings.Methods: This intervention study was conducted among HIV clients at the University of Nigeria Teaching Hospital and Enugu State University Teaching Hospital, which served as the intervention and control groups respectively. A nutrition education programme was delivered to the intervention group. In both groups, before and after the intervention, the body mass index of participants was calculated using their height (m2) and weight (kg) while their serum zinc levels were analysed using spectrophotometry. Chi-square and McNemar chi-square tests were used in the analysis.Results: A total of 185 respondents was studied in each group, with the majority in the 30-39 and 40-49 age groups, respectively (65.4% of the study group and 64.4% of the control group). Larger proportions of respondents in both groups were females (72.4% vs 75.1% respectively). Three months after the intervention, the proportion of respondents with normal serum zinc levels improved significantly from 20.5% to 51.9% in the intervention group (χ2McNemar, p < 0.001), whereas the control group had no appreciable improvement (16.8% vs 22.7%) (χ2McNemar, p < 0.117). Furthermore, the post-intervention serum zinc level difference between the intervention and control groups was statistically significant (χ2 = 33.699; p < 0.001). No statistically significant difference existed in the nutritional status between the groups (χ2 = 3.469; p = 0.325).Conclusion: Nutrition education had a positive effect on the serum zinc levels of HIV clients. Integrating nutrition education programmes as a key component of HIV care in resource-limited settings will help improve the serum zinc level of people living with HIV, which ultimately improves their immune status and life expectancy.
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Affiliation(s)
- Ifeyinwa Ezenwosu
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - Osita Ezenwosu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - Chinyere Mbachu
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - Ijeoma Itanyi
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - Emmanuel Aguwa
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu State, Nigeria
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Tekelehaimanot AN, Lemma TB, Gudina EK, Getnet M, Amdisa D, Dadi LS. Predictors of Under Nutrition and Its Implication toward HIV Continuum Care among Adult People Living with HIV in Jimma Zone Public Hospitals, Southwest Ethiopia: A Mixed Method Study. J Int Assoc Provid AIDS Care 2021; 19:2325958220976254. [PMID: 33297825 PMCID: PMC7734494 DOI: 10.1177/2325958220976254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: The study aimed to see predictors of undernourished and its implication towards HIV continuum care. Study Design: unmatched case-control study was conducted among 678 individuals in Jimma zone, southwest Ethiopia. Methods: Randomly selected data of 339 PLWHA who had poor nutritional outcomes (cases) and 339 without undernourished (controls) were analyzed. Logistic regression was used to identify forecasters of undernutrition. The quantitative results were supplemented from key informants who work closely on HIV care, then data were coded and analyzed thematically. Results: Rural residence (AOR:1.8; 95% CI: 1.2, 6.4), female (AOR: 2.9; 95% CI: 1.1, 4.3), unstable livelihood (AOR: 5.1; 95% CI: 4.2, 19.6), low meal frequency (AOR: 6.6; 95% CI: 5.2, 21.1), less diversified foods (AOR: 3.5; 95% CI: 1.2, 14.3), and advanced WHO clinical stage (AOR: 4.3; 95% CI: 3.6, 13.7) and were found to be independent predictors of undernourishment. No social support advanced clinical stage, and unstable livelihood adversely affect nutritional status of PLWHA from the qualitative data. Conclusions: The socio-cultural, economic, and health-system factors inhibit ideal patient nutritional status. Better tracking, enhanced livelihood and social support along with drug therapy, food aid needs to consider for PLWHA.
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Affiliation(s)
| | | | | | - Masrie Getnet
- Faculty of Public Health, 107839Jimma University, Jimma, Ethiopia
| | - Demuma Amdisa
- Faculty of Public Health, 107839Jimma University, Jimma, Ethiopia
| | - Lelisa Sena Dadi
- Faculty of Public Health, 107839Jimma University, Jimma, Ethiopia
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Cilliers K, Muller CJF. Effect of Human Immunodeficiency Virus on Trace Elements in the Brain. Biol Trace Elem Res 2021; 199:41-52. [PMID: 32239375 DOI: 10.1007/s12011-020-02129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/23/2020] [Indexed: 11/27/2022]
Abstract
Comorbidities of human immunodeficiency virus (HIV) include HIV-associated neurocognitive disorder (HAND). Changes in the brain due to HIV include atrophy, hyperintensities, and diffusion changes. However, no research has focused on trace elements concentration changes in the brain due to HIV, as seen in other neurodegenerative diseases. Therefore, the aim of this study was to determine the concentration of several trace elements in the brains of individuals with and without HIV infection. Prior to formalin embalming, blood was drawn and tested in triplicate with Determine HIV-1/2 rapid tests and confirmed with a SD HIV Device 1/2 3.0 rapid HIV Kit. After embalming, tissue was sampled from the caudate nucleus and analyzed using inductively coupled plasma mass spectrometry. A Kruskal-Wallis test was used to determine statistically significant differences between the two groups (p < 0.05). Fifteen HIV-positive and 14 HIV-negative male cadavers were included (mean age 44, range 22 to 61). Cadmium was marginally decreased, possibly due to malnutrition or utilization by the HIV nucleocapsid. Nickel was marginally increased, perhaps due to a reduced capability to remove metals from the body. In conclusion, this article provides the first information on trace element levels in the brains from HIV-infected individuals and postulates that cadmium and nickel may play a role in the pathophysiology of HAND. This information can contribute to finding a treatment for HAND, other than the use of antiretroviral drugs. Future studies should asses the levels of cadmium and nickel in a larger cohort of HIV-infected individuals.
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Affiliation(s)
- Karen Cilliers
- Division of Clinical Anatomy, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Western Cape, South Africa.
| | - Christo J F Muller
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council, Tygerberg, Western Cape, South Africa
- Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Western Cape, South Africa
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Monette A, Mouland AJ. Zinc and Copper Ions Differentially Regulate Prion-Like Phase Separation Dynamics of Pan-Virus Nucleocapsid Biomolecular Condensates. Viruses 2020; 12:E1179. [PMID: 33081049 PMCID: PMC7589941 DOI: 10.3390/v12101179] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/05/2020] [Accepted: 10/12/2020] [Indexed: 02/08/2023] Open
Abstract
Liquid-liquid phase separation (LLPS) is a rapidly growing research focus due to numerous demonstrations that many cellular proteins phase-separate to form biomolecular condensates (BMCs) that nucleate membraneless organelles (MLOs). A growing repertoire of mechanisms supporting BMC formation, composition, dynamics, and functions are becoming elucidated. BMCs are now appreciated as required for several steps of gene regulation, while their deregulation promotes pathological aggregates, such as stress granules (SGs) and insoluble irreversible plaques that are hallmarks of neurodegenerative diseases. Treatment of BMC-related diseases will greatly benefit from identification of therapeutics preventing pathological aggregates while sparing BMCs required for cellular functions. Numerous viruses that block SG assembly also utilize or engineer BMCs for their replication. While BMC formation first depends on prion-like disordered protein domains (PrLDs), metal ion-controlled RNA-binding domains (RBDs) also orchestrate their formation. Virus replication and viral genomic RNA (vRNA) packaging dynamics involving nucleocapsid (NC) proteins and their orthologs rely on Zinc (Zn) availability, while virus morphology and infectivity are negatively influenced by excess Copper (Cu). While virus infections modify physiological metal homeostasis towards an increased copper to zinc ratio (Cu/Zn), how and why they do this remains elusive. Following our recent finding that pan-retroviruses employ Zn for NC-mediated LLPS for virus assembly, we present a pan-virus bioinformatics and literature meta-analysis study identifying metal-based mechanisms linking virus-induced BMCs to neurodegenerative disease processes. We discover that conserved degree and placement of PrLDs juxtaposing metal-regulated RBDs are associated with disease-causing prion-like proteins and are common features of viral proteins responsible for virus capsid assembly and structure. Virus infections both modulate gene expression of metalloproteins and interfere with metal homeostasis, representing an additional virus strategy impeding physiological and cellular antiviral responses. Our analyses reveal that metal-coordinated virus NC protein PrLDs initiate LLPS that nucleate pan-virus assembly and contribute to their persistence as cell-free infectious aerosol droplets. Virus aerosol droplets and insoluble neurological disease aggregates should be eliminated by physiological or environmental metals that outcompete PrLD-bound metals. While environmental metals can control virus spreading via aerosol droplets, therapeutic interference with metals or metalloproteins represent additional attractive avenues against pan-virus infection and virus-exacerbated neurological diseases.
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Affiliation(s)
- Anne Monette
- Lady Davis Institute at the Jewish General Hospital, Montréal, QC H3T 1E2, Canada
| | - Andrew J. Mouland
- Lady Davis Institute at the Jewish General Hospital, Montréal, QC H3T 1E2, Canada
- Department of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
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Alebel A, Kibret GD, Petrucka P, Tesema C, Moges NA, Wagnew F, Asmare G, Kumera G, Bitew ZW, Ketema DB, Tiruneh T, Melkamu MW, Hibstie YT, Temesgen B, Eshetie S. Undernutrition among Ethiopian adults living with HIV: a meta-analysis. BMC Nutr 2020; 6:10. [PMID: 32322404 PMCID: PMC7161140 DOI: 10.1186/s40795-020-00334-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 02/12/2020] [Indexed: 11/19/2022] Open
Abstract
Background Malnutrition and human immunodeficiency virus (HIV) are interlaced in a vicious cycle and worsened in low and middle-income countries. In Ethiopia, even though individuals are dually affected by both malnutrition and HIV, there is no a nationwide study showing the proportion of malnutrition among HIV-positive adults. Consequently, this review addressed the pooled burden of undernutrition among HIV-positive adults in Ethiopia. Methods We searched for potentially relevant studies through manual and electronic searches. An electronic search was carried out using the database of PubMed, Google Scholar, and Google for gray literature and reference lists of previous studies. A standardized data extraction checklist was used to extract the data from each original study. STATA Version 13 statistical software was used for our analysis. Descriptive summaries were presented in tables, and the quantitative result was presented in a forest plot. Heterogeneity within the included studies was examined using the Cochrane Q test statistics and I2 test. Finally, a random-effects meta-analysis model was computed to estimate the pooled proportion of undernutrition among HIV-positive adults. Results After reviewing 418 studies, 15 studies met the inclusion criteria and were included in the meta-analysis. Findings from 15 studies revealed that the pooled percentage of undernutrition among HIV-positive adults in Ethiopia was 26% (95% CI: 22, 30%). The highest percentage of undernutrition (46.8%) was reported from Jimma University specialized hospital, whereas the lowest proportion of undernutrition (12.3%) was reported from Dilla Hospital. The subgroup analyses of this study also indicated that the percentage of undernourishment among HIV-positive adults is slightly higher in the Northern and Central parts of Ethiopia (27.5%) as compared to the Southern parts of Ethiopia (25%). Conclusion This study noted that undernutrition among HIV-positive adults in Ethiopia was quite common. This study also revealed that undernutrition is more common among HIV-positive adults with advanced disease stage, anemia, diarrhea, CD4 count less than 200 cells/mm3, and living in rural areas. Based on our findings, we suggested that all HIV-positive adults should be assessed for nutritional status at the time of ART commencement.
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Affiliation(s)
- Animut Alebel
- 1College of Health Science, Debre Markos University, Debre Markos, Ethiopia.,2Faculty of Health, University of Technology Sydney, Sydney, Australia
| | | | - Pammla Petrucka
- 3College of Nursing, University of Saskatchewan, Saskatoon, Canada.,4School of Life Sciences and Bioengineering, Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
| | - Cheru Tesema
- 1College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | | | - Fasil Wagnew
- 1College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Getnet Asmare
- Department of Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gemechu Kumera
- 1College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Zebenay Workneh Bitew
- 6Department of Nursing, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | | | | | | | | | - Setegn Eshetie
- 8College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Monette A, Niu M, Chen L, Rao S, Gorelick RJ, Mouland AJ. Pan-retroviral Nucleocapsid-Mediated Phase Separation Regulates Genomic RNA Positioning and Trafficking. Cell Rep 2020; 31:107520. [PMID: 32320662 PMCID: PMC8965748 DOI: 10.1016/j.celrep.2020.03.084] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/12/2020] [Accepted: 03/24/2020] [Indexed: 02/07/2023] Open
Abstract
The duality of liquid-liquid phase separation (LLPS) of cellular components into membraneless organelles defines the nucleation of both normal and disease processes including stress granule (SG) assembly. From mounting evidence of LLPS utility by viruses, we discover that HIV-1 nucleocapsid (NC) protein condenses into zinc-finger (ZnF)-dependent LLPSs that are dynamically influenced by cytosolic factors. ZnF-dependent and Zinc (Zn2+)-chelation-sensitive NC-LLPS are formed in live cells. NC-Zn2+ ejection reverses the HIV-1 blockade on SG assembly, inhibits NC-SG assembly, disrupts NC/Gag-genomic RNA (vRNA) ribonucleoprotein complexes, and causes nuclear sequestration of NC and the vRNA, inhibiting Gag expression and virus release. NC ZnF mutagenesis eliminates the HIV-1 blockade of SG assembly and repositions vRNA to SGs. We find that NC-mediated, Zn2+-coordinated phase separation is conserved among diverse retrovirus subfamilies, illustrating that this exquisitely evolved Zn2+-dependent feature of virus replication represents a critical target for pan-antiretroviral therapies.
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Affiliation(s)
- Anne Monette
- HIV-1 RNA Trafficking Laboratory, Lady Davis Institute at the Jewish General Hospital, Montréal, QC H3T 1E2, Canada.
| | - Meijuan Niu
- HIV-1 RNA Trafficking Laboratory, Lady Davis Institute at the Jewish General Hospital, Montréal, QC H3T 1E2, Canada
| | - Lois Chen
- HIV-1 RNA Trafficking Laboratory, Lady Davis Institute at the Jewish General Hospital, Montréal, QC H3T 1E2, Canada; Department of Microbiology and Immunology, McGill University, Montréal, QC H3A 2B4, Canada
| | - Shringar Rao
- HIV-1 RNA Trafficking Laboratory, Lady Davis Institute at the Jewish General Hospital, Montréal, QC H3T 1E2, Canada; Department of Biochemistry, Erasmus University Medical Center, Ee634, PO Box 2040, 3000CA Rotterdam, the Netherlands
| | - Robert James Gorelick
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD 21701, USA
| | - Andrew John Mouland
- HIV-1 RNA Trafficking Laboratory, Lady Davis Institute at the Jewish General Hospital, Montréal, QC H3T 1E2, Canada; Department of Microbiology and Immunology, McGill University, Montréal, QC H3A 2B4, Canada; Department of Medicine, McGill University, Montréal, QC H3G 2M1, Canada.
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Ageru TA, Koyra MM, Gidebo KD, Abiso TL. Anemia and its associated factors among adult people living with human immunodeficiency virus at Wolaita Sodo University teaching referral hospital. PLoS One 2019; 14:e0221853. [PMID: 31596865 PMCID: PMC6785157 DOI: 10.1371/journal.pone.0221853] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/17/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In Sub-Saharan Africa, both HIV/AIDS and anemia have considerable public health problems. Anemia has an adverse effect on treatment outcome and it decreases the quality of life among adult HIV patients. This study was aimed to assess the prevalence of anemia and its associated factors among adult HIV positive patients in Wolaita Sodo University Teaching Referral Hospital. METHOD Institution based cross-sectional study was conducted at Wolaita Sodo University Teaching Referral Hospital from 01 October to December 30, 2016. A randomly selected 411 adult people living with the human immunodeficiency virus were included in the study. A pre-tested questionnaire was used to collect data. Variables with P-value ≤0.25 in the bivariable logistic regression model were taken into multivariable logistic regression analysis along with 95% confidence interval and Odds Ratio was used to examine the association between anemia and independent variables. P-value ≤ 0.05 was taken as statistically significant. RESULT Prevalence of anemia in this study was 36.5% with 95% CI (32%-41%). Factors associated with anemia among adult people living with HIV/AIDS were individuals who lived with HIV ≥9years (AOR = 2.6, 95% CI:-1.03-6.59),years lived with HIV 5-8 years (AOR = 2.59, 95% CI:-1.02-6.57),CD4 count <200cells/ul (AOR = 4.2, 95%CI:-2.03-8.67), CD4 count200-350cells/ul(AOR = 1.82,95%CI:-1.01-3.26),infection with intestinal parasites (AOR = 2.04, 95% CI:-1.06-3.95), Participants with BMI <18.5kg/m2 (AOR = 2.96, 95%CI:-1.37-6.390),BMI 18.5-25kg/m2(AOR = 1.98, 95%CI:-1.11-3.56) and being HAART naïve (AOR = 2.23, 95% CI:- 1.16-4.28). CONCLUSION Prevalence of anemia among this study participant was high. This may affect the treatment outcome, increases morbidity and mortality of the participants. So periodic screening of anemia, a routine checkup of nutritional status, CD4 count and examination for intestinal parasite are essential.
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Affiliation(s)
| | - Mengistu Meskele Koyra
- School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Wolaita Sodo, South Ethiopia
| | - Kassa Daka Gidebo
- School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Wolaita Sodo, South Ethiopia
| | - Temesgen Lera Abiso
- School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Wolaita Sodo, South Ethiopia
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Negessie A, Jara D, Taddele M, Burrowes S. Determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: a case-control study design. BMC Nutr 2019; 5:20. [PMID: 32153933 PMCID: PMC7050723 DOI: 10.1186/s40795-019-0284-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 02/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background A complex and negatively reinforcing relationship exists between infection with Human Immune Deficiency Virus (HIV) and malnutrition. HIV-induced immune impairment and its resulting opportunistic infections (OIs) can lead to malnutrition and nutritional deficits, can, in turn, hasten the progression of HIV infection and reduce chances of survival. The determinants of undernutrition among patients receiving antiretroviral therapy (ART) is poorly understood in Ethiopia, despite a high prevalence of food-insecurity that overlaps with a generalized HIV/AIDS epidemic. Therefore, this study aimed to assess determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos Referral Hospital in Northwest Ethiopia. Methods We conducted an institution-based, unmatched, case-control study with 636 adult patients receiving antiretroviral therapy. We randomly selected 212 patients with poor nutritional outcomes (cases) and 424 without undernutrition (controls) and then conducted a chart review to collect information on their treatment, socio-economic, and demographic background. Data were analyzed using bivariable and multivariable logistic regression to identify factors associated with under nutrition. Results We found that greater age (AOR = 1.02, 95% CI: 1.01,1.05), fair or poor adherence (AOR = 2.77, 95% CI: 1.40, 5.50 and AOR = 4.72, 95% CI: 1.92, 11.6), and the presence of OIs (AOR = 1.70, 95% CI: 1.12, 2.52), anemia (AOR = 1.81, 95% CI: 1.07, 3.07), or eating problems (AOR = 3.40, 95% CI: 2.27, 5.10), were all independently and positively associated with under nutrition. Starting treatment with a medium or low CD4 count was protective (AOR = 0.61, 95% CI: 0.39, 0.96 and AOR = 0.49, 95% CI: 0.27, 0.88). Having social support (AOR = 0.64, 95% CI: 0.43, 0.95), and having a source of informal care-giving (AOR = 0.48, 95% CI: 0.27, 0.84), reduced the odds of undernutrition. Conclusion Our findings support calls for treating HIV infection early and aggressively, while closely monitoring patients for opportunistic infections that might affect eating and drug side effects that may affect appetite. The role of disclosure, peer-caregivers and age in preventing undernutrition should be explored in future research.
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Affiliation(s)
- Ayenew Negessie
- 1Department of Nutrition and Food Sciences, College of Medicine and Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Dube Jara
- 2Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Mekaunint Taddele
- 2Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Sahai Burrowes
- 3Public Health Program, College of Education and Health Sciences, Touro University California, 1310 Club Drive, Mare Island, Vallejo, CA 94592 USA
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Zinc, copper, CD4 T-cell count and some hematological parameters of HIV-infected subjects in Southern Nigeria. Integr Med Res 2018; 7:53-60. [PMID: 29629291 PMCID: PMC5884009 DOI: 10.1016/j.imr.2018.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 01/17/2018] [Accepted: 01/22/2018] [Indexed: 11/26/2022] Open
Abstract
Background Low concentration of trace elements has been associated with poor prognosis and mortality in HIV infection. Methods A cross sectional study was conducted among 100 HIV-infected subjects (70 were on ART treatment, while 30 were ART naïve). Fifty (50) apparently healthy controls were enrolled. Concentration of serum levels of zinc and copper was done using atomic absorption spectrometric method, while complete blood count was determined using automated blood analyzer. CD4+ T-cell count was done using cyflow cytometer. Aim and setting The aim of this study was to investigate the level of some trace elements and some hematological parameters of HIV-seropositive subjects attending University of Calabar Teaching Hospital Clinic as well as prevalence of trace elements deficiency and anemic status and compare same with HIV-seronegative control. Results Mean serum zinc, CD4+ T-cell count, Hb, PCV, RBC, MXD, were significantly (p < 0.05) reduced in the HIV-infected subjects, while copper/zinc ratio, MCV, MCH and platelet count were significantly (p < 0.05) raised in the HIV-infected subjects. The serum Cu level was comparable (p > 0.05) with the control. ART treatment had no effect on all the parameters assessed except CD4+ T-cell count. Twenty five percent (25%), 3% and 56% of the HIV-infected subjects were zinc deficient, copper deficient and anemic, respectively. Gender was found as a predictor of zinc deficiency. Copper and zinc showed weak positive correlation with CD4+ T-cell count. Conclusion ART treatment did not complement zinc status in HIV infection while improving CD4+ T-cell count, hence the need to consider supplementation.
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Weldehaweria NB, Abreha EH, Weldu MG, Misgina KH. Psychosocial correlates of nutritional status among people living with HIV on antiretroviral therapy: A matched case-control study in Central zone of Tigray, Northern Ethiopia. PLoS One 2017; 12:e0174082. [PMID: 28301592 PMCID: PMC5354448 DOI: 10.1371/journal.pone.0174082] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 03/03/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Malnutrition hastens progression to Acquired Human Immunodeficiency Syndromes (AIDS) related illnesses; undermines adherence and response to antiretroviral therapy (ART) in resource-poor settings. However, nutritional status of people living with HIV (PLHIV) can be affected by various psychosocial factors which have not been well explored in Ethiopia. Therefore, the objective of this study was to determine psychosocial correlates of nutritional status among people living with HIV (PLHIV) on ART in Central zone of Tigray, Northern Ethiopia. METHODS A matched case-control study design was conducted to assess psychosocial correlates of nutritional status among PLHIV on ART. Data were collected by an interviewer-administered technique using structured pre-tested questionnaire, record review using a checklist and anthropometric measurements. Cases were selected by simple random sampling and controls purposively to match the selected cases. Conditional logistic regression was used to compute relevant associations by STATA version 12. RESULTS The psychosocial factors independently associated with malnutrition were ever consuming alcohol after starting ART [AOR = 4.7, 95% CI: 1.8-12.3], ever smoking cigarette after starting ART [AOR = 7.6, 95% CI: 2.3-25.5], depression [AOR = 2.8, 95% CI: 1.3, 6.1], not adhering to ART [AOR = 6.8,95% CI: 2.0-23.0] and being in the second lowest wealth quintile [AOR = 4.3,95% CI: 1.1-17.7]. CONCLUSION Ever consuming alcohol and ever smoking cigarette after starting ART, depression, not adhering to ART and being in the second lowest wealth quintile were significantly associated with malnutrition. Therefore; policies, strategies, and programs targeting people living with HIV should consider psychosocial factors that can impact nutritional status of people living with HIV enrolled on ART.
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Affiliation(s)
| | - Elsa Hagos Abreha
- Department of Biomedical Sciences, College of Health Sciences, Semara University, Semara, Afar, Ethiopia
| | - Meresa Gebremedhin Weldu
- Department of Public Health, College of Health Sciences, Aksum University, Aksum, Tigray, Ethiopia
| | - Kebede Haile Misgina
- Department of Public Health, College of Health Sciences, Aksum University, Aksum, Tigray, Ethiopia
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Poudel KC, Bertone-Johnson ER, Poudel-Tandukar K. Serum Zinc Concentration and C-Reactive Protein in Individuals with Human Immunodeficiency Virus Infection: the Positive Living with HIV (POLH) Study. Biol Trace Elem Res 2016; 171:63-70. [PMID: 26429417 DOI: 10.1007/s12011-015-0520-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/23/2015] [Indexed: 12/15/2022]
Abstract
Low zinc levels and chronic inflammation are common in individuals infected with human immunodeficiency virus (HIV). Zinc deficiency may promote systemic inflammation, but research on the role of zinc in inflammation among HIV-positive individuals taking account of anti-retroviral therapy is lacking. We assessed the association between serum zinc and C-reactive protein (CRP) concentration in a cohort of HIV-positive individuals. A cross-sectional survey was conducted among 311 HIV-positive individuals (177 men and 134 women) aged 18-60 years residing in Kathmandu, Nepal. High-sensitive or regular serum CRP concentrations were measured by the latex agglutination nephelometry or turbidimetric method, and zinc concentrations were measured by the atomic absorption method. Relationships were assessed using multiple linear regression analysis. The geometric means of zinc in men and women were 73.83 and 71.93 ug/dL, respectively, and of CRP were 1.64 and 0.96 mg/L, respectively. Mean serum CRP concentration was significantly decreased with increasing serum zinc concentration across zinc tertiles (P for trend = 0.010), with mean serum CRP concentration in the highest tertile of serum zinc concentration was 44.2 % lower than that in the lowest tertile. The mean serum CRP concentrations in men and women in the highest tertile of serum zinc concentrations were 30 and 35.9 % lower, respectively, than that in the lowest tertile (P for trend = 0.263 and 0.162, respectively). We found a significant inverse relation between log zinc and log CRP concentrations (beta for 1 unit change in log zinc; β = -1.79, p = 0.0003). Serum zinc concentration may be inversely associated with serum CRP concentration in HIV-positive individuals.
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Affiliation(s)
- Krishna C Poudel
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 316 Arnold House, 715 North Pleasant St, Amherst, MA, 01003-9304, USA.
| | - Elizabeth R Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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Quadruple burden of HIV/AIDS, tuberculosis, chronic intestinal parasitoses, and multiple micronutrient deficiency in ethiopia: a summary of available findings. BIOMED RESEARCH INTERNATIONAL 2015; 2015:598605. [PMID: 25767808 PMCID: PMC4342072 DOI: 10.1155/2015/598605] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 01/26/2015] [Indexed: 12/20/2022]
Abstract
Human immunodeficiency virus (HIV), tuberculosis (TB), and helminthic infections are among the commonest public health problems in the sub-Saharan African countries like Ethiopia. Multiple micronutrient deficiencies also known as the “hidden hunger” are common in people living in these countries either playing a role in their pathogenesis or as consequences. This results in a vicious cycle of multiple micronutrient deficiencies and infection/disease progression. As infection is profoundly associated with nutritional status resulting from decreased nutrient intake, decreased nutrient absorption, and nutrient losses, micronutrient deficiencies affect immune system and impact infection and diseases progression. As a result, micronutrients, immunity, and infection are interrelated. The goal of this review is therefore to provide a summary of available findings regarding the “quadruple burden trouble” of HIV, TB, intestinal parasitic infections, and multiple micronutrient deficiencies to describe immune-modulating effects related to disorders.
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Abstract
OBJECTIVES To describe the epidemiology and an aetiological model of ocular surface squamous neoplasia (OSSN) in Africa. METHODS Systematic and non-systematic review methods were used. Incidence was obtained from the International Agency for Research on Cancer. We searched PubMed, EMBASE, Web of Science and the reference lists of articles retrieved. Meta-analyses were conducted using a fixed-effects model for HIV and cigarette smoking and random effects for human papilloma virus (HPV). RESULTS The incidence of OSSN is highest in the Southern Hemisphere (16° South), with the highest age-standardised rate (ASR) reported from Zimbabwe (3.4 and 3.0 cases/year/100 000 population for males and females, respectively). The mean ASR worldwide is 0.18 and 0.08 cases/year/100 000 among males and females, respectively. The risk increases with exposure to direct daylight (2-4 h, OR = 1.7, 95% CI: 1.2-2.4 and ≥5 h OR = 1.8, 95% CI: 1.1-3.1) and outdoor occupations (OR = 1.7, 95% CI: 1.1-2.6). Meta-analysis also shows a strong association with HIV (6 studies: OR = 6.17, 95% CI: 4.83-7.89) and HPV (7 studies: OR = 2.64, 95% CI: 1.27-5.49) but not cigarette smoking (2 studies: OR = 1.40, 95% CI: 0.94-2.09). The effect of atopy, xeroderma pigmentosa and vitamin A deficiency is unclear. CONCLUSIONS Africa has the highest incidence of OSSN in the world, where males and females are equally affected, unlike other continents where male disease predominates. African women probably have increased risk due to their higher prevalence of HIV and HPV infections. As the survival of HIV-infected people increases, and given no evidence that anti-retroviral therapy (ART) reduces the risk of OSSN, the incidence of OSSN may increase in coming years.
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Affiliation(s)
- Stephen Gichuhi
- Department of Ophthalmology, University of NairobiNairobi, Kenya
- London School of Hygiene and Tropical MedicineLondon, UK
| | - Mandeep S Sagoo
- Moorfields Eye HospitalLondon, UK
- UCL Institute of Ophthalmology, University College LondonUK
| | - Helen A Weiss
- London School of Hygiene and Tropical MedicineLondon, UK
| | - Matthew J Burton
- London School of Hygiene and Tropical MedicineLondon, UK
- Moorfields Eye HospitalLondon, UK
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Hadgu TH, Worku W, Tetemke D, Berhe H. Undernutrition among HIV positive women in Humera hospital, Tigray, Ethiopia, 2013: antiretroviral therapy alone is not enough, cross sectional study. BMC Public Health 2013; 13:943. [PMID: 24107008 PMCID: PMC3852443 DOI: 10.1186/1471-2458-13-943] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 10/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Ethiopia, undernutrition among women on antiretroviral therapy has been a major challenge to achieve the full impact of intervention. Twenty seven percent and 17% of reproductive age Ethiopian women are chronically malnourished and anemic, respectively. Most studies to examine risk factors have been limited to the general population and ART-naive HIV-positive women, making it difficult to generalize findings to ART-treated HIV-positive women. The objectives of this study were thus to assess nutritional status and associated factors among adult women (≥ 20 years) on antiretroviral therapy. METHODS From August to September we conducted an Institution based cross-sectional survey among 276 women on antiretroviral therapy in Humera Hospital, Tigray, Ethiopia. Data was collected using structured and standard face to face interview, anthropometric measurements, BD FACS (CD4 count machine) and Sysmex-21 (hemoglobin analyzer). Logistic regression was done using SPSS version 16 to identify factors that are associated with nutritional status. RESULTS The prevalence of under nutrition (Body mass index < 18.5 kg/m(2)) Was 42.3% (95% CI: 37.4% - 47.3%). Severe, moderate and mild under nutrition was detected on 12%, 10% and 20.3% respondents, respectively. The prevalence of wasting (percentage body weight loss >5%) was 75% (95% CI: 70.4% - 79.2%). Severe wasting was accounted for 26.9% of respondents.In the multivariate analysis, Household food insecurity [AOR = 1.85; 95%CI 1.16, 2.86], inadequate dietary diversity [AOR = 1.19; 95%CI 1.08, 1.75], anemia [AOR = 1.67; 95%CI 1.05, 2.65] and absence of nutritional support [AOR = 0.34 95%CI 0.22, 0.54) were found to be independent predictors of under-nutrition. CONCLUSION HIV/AIDS is associated with an increased burden of undernutrition even among ART treated women in Humera Hospital, Tigray, Ethiopia. In addition to ART among HIV positive women interventions to ameliorate poor nutritional status may be necessary in this and similar settings. Such interventions aimed at improving household food security, dietary diversity, micronutrient supplementation, proper use of therapeutic food, as well as treating oral candidiasis.
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Affiliation(s)
| | - Walelegn Worku
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desalegn Tetemke
- Department of Public Health, College of Health Sciences, Axum University, Axum, Ethiopia
| | - Hailemariam Berhe
- Department of Nursing, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Zeng L, Zhang L. Efficacy and safety of zinc supplementation for adults, children and pregnant women with HIV infection: systematic review. Trop Med Int Health 2011; 16:1474-82. [DOI: 10.1111/j.1365-3156.2011.02871.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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